2022 DRHS Animal C.A.R.E. Summer Humane Education

2022 Animal C.A.R.E. Summer Programs Registration
Please complete one registration form per camper per camp. Confirmation emails with important camp information will be sent following registration. Please feel free to contact us at info@dbqhumane.org with any questions or concerns.

Camp cost includes a t-shirt, snack, and supplies used during camp.
Camper Information
Name (one camper per registration) *

First Name Last Name
Age at time of camp *
School attending *
Grade (Fall of 2022) *
T-Shirt Size *
Please list all allergies or dietary restrictions or requirements.
Does this student face adversity of any kind? (i.e. financially, racially, socially).

Yes No
List any medical or behavioral concerns that requires special attention or considerations; please provide any information which may be helpful to camp staff.
Parent/Guardian Information
Name *

First Name Last Name
Email *
example@example.com
Primary Phone Number *

Area Code Phone Number
Additional Phone Number

Area Code Phone Number
Home Address *

Street Address

Street Address Line 2

City State

Zip Code
Emergency Contact
Name *

First Name Last Name
Primary Phone Number *

Area Code Phone Number
Additional Phone Number

Area Code Phone Number
Choose Your Camp!
Camp Sessions (Single Selection) *

Grades 1 - 3: WEEKLONG CAMP July 11 - 15 from 9 a.m. - 12 p.m. ($200) Grades 4 - 6: WEEKLONG CAMP July 11 - 15 from 1 p.m. - 4 p.m. ($200) Grades 1 - 3: WEEKLONG CAMP August 1 - 5 from 9 a.m. - 12 p.m. ($200) Grades 4 - 6: WEEKLONG CAMP August 1 - 5 from 1 p.m. - 4 p.m. ($200) Grades 6 - 12: VET SHADOW DAY August 9 from 9 a.m. - 1 p.m. ($80)
Payment Type
Please Select Payment Type

Credit or Debit Card Apply for Scholarship

Credit or Debit Card Payment

Select Your Camp(s)

Grades 1 - 3: WEEKLONG CAMP July 11 - 15 from 9 a.m. - 12 p.m. $ 200.00

Grades 4 - 6: WEEKLONG CAMP July 11 - 15 from 1 p.m. - 4 p.m. $ 200.00

Grades 1 - 3: WEEKLONG CAMP August 1 - 5 from 9 a.m. - 12 p.m. $ 200.00

Grades 4 - 6: WEEKLONG CAMP August 1 - 5 from 1 p.m. - 4 p.m. $ 200.00

Grades 6 - 12: VET SHADOW DAY August 9 from 9 a.m. - 1 p.m. $ 80.00

Total $ 0.00

Credit or Debit Card Details
First Name	Last Name
Credit Card Number	Security Code

Scholarships
Scholarships are offered to campers who, without this option, would be unable to attend camp.

All applicants will be considered; scholarships will be awarded based on financial need, number of requested scholarships, and available funding.

If applying for a scholarship, an invoice will be sent through the mail for any remaining balance not covered after confirming the scholarship by phone call.
Partial or Full Scholarship *
Camp Session

Grades 1 - 3: WEEKLONG CAMP July 11 - 15 from 9 a.m. - 12 p.m. ($200) Grades 4 - 6: WEEKLONG CAMP July 11 - 15 from 1 p.m. - 4 p.m. ($200) Grades 1 - 3: WEEKLONG CAMP August 1 - 5 from 9 a.m. - 12 p.m. ($200) Grades 4 - 6: WEEKLONG CAMP August 1 - 5 from 1 p.m. - 4 p.m. ($200) Grades 6 - 12: VET SHADOW DAY August 9 from 9 a.m. - 1 p.m. ($80)
Please give a brief description as to why your camper should be considered for a scholarship.

Should be Empty: